training annual report-2016-17 - nrhmorissa.gov.in · training status report 2016-17 mission...

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Training Status Report 2016-17

Mission Directorate National Health Mission

Department of Health & Family Welfare Govt. of Odisha

April,2017

Training Unit, NHM- Odisha

Training Status Report

Institutional Structure

Commissioner cum Secretary



DEMOGRAPHIC PROFILE AND VITAL HEALTH INDICATORS IN ODISHA

HEALTH INSTITUTION

# of Govt. Medical College & Hospitals (MCH) 3

# of District Head Quarter Hospitals (DHH) 32

# of Sub- Divisional Hospitals (SDH) 27

# of Nursing College 1

# of ANM Training Centre 19

# of GNM Training Centre 8

# of CHCs ( Non- FRU) 339

# of CHCs ( FRU) 38

# of DHH FRUs 32

# of SDH FRUs 25

# of 24X7 PHCs/ OHs 126

# of any other PHCs/ OHs 1179

# of Sub- Centres 6688

Total Population (Census-2011) M – 212,12,136 F – 207,62,082 419,74,218

Literacy Rate (Census-2011) M – 81.59%, F – 64.01% 72.87%

Sex Ratio (NFHS-4) 1036

Child Population 0-6-years (Census-2011) 5273194

Child Sex Ratio (0-6 years) (Census-2011) 941

Natural Growth Rate (SRS -2015) 11.6

Crude Birth Rate (SRS -2015) 19.2

Crude Death Rate (SRS -2015) 7.6

Maternal Mortality Rate (SRS:2011-13) 222

Infant Mortality Rate (NFHS-4) 40

Total Fertility Rate (SRS -2015) 2.0

Source: HMIS, NHM


Training Status Report Introduction:

Better quality of health care services at health institution depends on continuous skill building of medical and paramedical personnel. Skill up-gradation is the call of the day. As per the requirement of institutions and the need of the health personnel, the paradigm of training has been shifted from training to quality health care services through skill building, multi skilling & mentoring. Skill building training like SBA, BEmOC, RTI/STI and FP trainings are conducted to ensure the quality of services. Multi skilling of MBBS doctors on Life Saving Anaesthetic Skills (LSAS), Emergency Obstetric Care (EmOC), Blood Storage Unit (BSU) management training are conducted to functionalise designated First Referral Units (FRUs).

Objectives: To improve the skills and to enable the service providers to ensure high quality services. To develop management skills of health personnel for effective management of public health. To strengthen the service delivery mechanism through multiskilling of health personnel at FRU and 24x7

Institutions.

Major Achievements: As approved in PIP FY:2016-17 NHM, Dept. of H&FW, Govt. of Odisha has implemented training on

RMNCH+A, Multi Skilling, Programme Management training at different levels to achieve the NHM goal. Major training programmes during FY: 2016-17 are as follows: Reproductive Health:

Training Target Achievement % Laparoscopic Sterilization (Team) 15 team 15 team 100%

Minilap (MO) 33 batch 16 batch 48%

NSV (MO) 13 batch 6 batch 46% IUCD (MO, AYSUH MO, SN, ANM/LHV) 140 batch 101 batch 72%

PPIUCD (MO, SN) 68 batch 51 batch 75%

100%

48% 46%

72% 75%

0%10%20%30%40%50%60%70%80%90%

100%

Laporoscopic Minilap NSV IUCD PPIUCD


Training Status Report Laparoscopic Sterilization: Training for a team of three members (MO, SN and OT attendant) organized at State and Regional level for 12 working days. Total 15 team of MOs, SNs and OT attendants have been trained during the year 2016-17 against the target of 15 teams. Minilap: It is a training for twelve working day for Assistant Surgeon posted at L2 & L3 institutions. During FY: 16-17, total 48 Medical Officers have been trained against the target of 99 personnel. NSV (Non Scalpel Vasectomy): It is a training for five working day for Medical Officers. Total 24 MOs have been trained during the year 2016-17 against the target 52 personnel. IUCD (Intra Uterine Contraceptive Devices) During FY: 2016-17, 1010 MOs, AYUSH MOs, SNs and ANMs & LHVs have been trained against the target of 1400 personnel. PPIUCD: (Post Partum Intra Uterine Contraceptive Devices) During FY: 2016-17, total 510 MOs & SNs have been trained against the target 680 personnel. 1. Maternal Health:

SAB LSAS CAC BEmOC Dakshata RTI/STI GDM BSU

% 75% 75% 74% >100% 82% 100% 45% 50%

Ach 549 9 31 batch 124 56 6 batch 25 batch 1 batch

Target 730 12 42 batch 100 68 6 batch 56 batch 2 batch

75% 75% 74%

100%

82%

100%

45%50%

0%10%20%30%40%50%60%70%80%90%

100%

SAB LSAS CAC BEmOC Dakshata RTI/STI GDM BSU

Trainees of IUCD training


Training Status Report Skill Attendant at Birth (SAB): It is implemented since 2007 to reduce the Maternal Mortality Ratio

(MMR) and Infant Mortality Rate (IMR) of the State. Total 549 (S Ns-192 and ANM&LHVs- 357) have

been trained against the load of 730 during FY’ 2016-17.

BEmOC (Basic Emergency Obstetric Care): Odisha is the 1st State in the country to implement 10 days

BEmOC training for MBBS Doctors of L2 and L3 institution.

During 2016-17, total 124 MBBS doctors have been trained

against the target of 100 at Dept. of OG, SCB Medical College

and Hospital, Cuttack (SCB, MCH, Cuttack).

LSAS (Life Saving Anaesthetic Skills): It is organized at Dept. of Anaesthesiology of Govt. Medical colleges since October 2007. Total 158 doctors have been trained since 2007. Dr. Nibedita Pani, Prof. Anaestheisiology, SCB MCH, Cuttack has been awarded as the best master trainer of the State in LSAS training at National level by Govt. of India.

During 2016-17 total 9 MBBS doctors have been trained and posted at FRU to administer spinal anesthesia during Emergency Obstetric Care (EmOC) service.

Blood Storage Unit (BSU) management training: To functionalise FRU, provision of blood is mandatory. To ensure availability of blood for C-section, 3 day BSU Management training is implemented by NHM, Odisha at Red Cross Blood Bank, Capital Hospital, Bhubaneswar. MO & LT of BSU are trained to functionalize blood storage unit. During 2016-17 1batch (MO-9, LT -7) have been trained against the target of 2 batches (30 participants).

Trainees of LSAS training

Trainees are in 21 days SAB Training

Trainees are in BSU training

BEmOC training at SCB MCH, Cuttack


Training Status Report New Born & Child Health:

IMNCI FIMNCI NSSK NRC FBNC IYCF CDR

% 86% 30% 51% 72% >100% 100% 77%

Ach 329 143 287 125 84 18 batch 206

Target 384 480 562 174 72 18 batch 266

Facility Based Integrated Management of Neo natal Childhood Illness ( F-IMNCI) Facility Based Integrated Management of Neo natal Childhood Illness ( F-IMNCI) training is provided to the MOs & SNs of L2 & L3 institutions. It is a 11 days training conducted at Regional training venue. The trained personnel provides curative care as per the standard protocol of FIMNCI training at institution level. During home visit by the IMNCI trained personnel, cases are referred for treatment by the F-IMNCI trained personnel. During 2016-17 total 143 MOs & SNs have been trained against the target of 480.

Integrated Management of Neonatal Childhood Illness: IMNCI training initiated since 2007. Total 20 High burden of IMR Districts are covered under IMNCI training. Till March’17 total 42734 personnel (AYUSH MO, ANM, LHV, MPHS, ICDC Supervisor, & CDPO) have been trained. During 2016-17 total 329 paramedical personnel (ANMs & LHVs ) have been trained against the target of 384.

86%

30%

51%

72%

100% 100%77%

0%10%20%30%40%50%60%70%80%90%

100%

IMNCI FIMNCI NSSK NRC FBNC IYCF CDR-Verbal

Autopsy

F-IMNCI training at State level

IMNCI training at District level


Training Status Report Facility Based Newborn Care (FBNC) : FBNC training is provided to SNs and MOs of Special New Born Care Unit (SNCU) and New Born Stabilization Unit (NBSU), established at DHH & FRU respectively. It is a 4 day training at state level followed by 11 days observership training at KEM, Mumbai and Safadarzang Hospital, Delhi. The MOs and SNs are competent enough to provide quality services at SNCU and NBSU. During FY: 2016-17, total 84 MOs and SNs have been trained against the target of 72.

Navjat Sishu Surakshya Karyakram (NSSK): During FY: 2016-17, total 287 medical and paramedical personnel (Medical officers & SNs of L1, L2, L3 institutions) from 30 districts have been trained. Trained personnel are posted at the labour room to conduct delivery & neonatal resuscitation.

Infant Young Child Feeding (IYCF): It is 3 days state level training for the SNs and ANM. The objective of IYCF training is to enhance the knowledge and skill of ANM & SNs on proper feeding and care practices for under 5 children and to provide better counselling skills for the mother and care giver of children admitted at Paediatric IPD of all 30 DHH. This training is conducted in collaboration with National Nutrition Board (NNB) to ensure the quality of training and to ensure proper implementation of standard protocol. During 2016-17 total 18 batches have been trained against the target of 18 batches (518-ANMs). Adolescent Health: Rastriya Kishore Swasthya Karyakram (RKSK) The objective of RKSK training is to ensure the quality service at Adolescent Friendly Health Centre (AFHC) for both adolescent male and female. RKSK training is provided to create demand among the adolescents and to ensure timely referral of the adolescents. Under Adolescent Health, confidentiality is an important aspect which is stressed upon during training. RKSK training is provided to the MOs (TOT) & ANM at the grass root level. During 2016 – 17, total 13 batches of AFHS (ANM/LHV) training completed against the target of 26 batches. At and 39 batches trained out of 738.

Year: 2016-17 AFHS – ANM/LHV AFHS – Counselors ToT for ANM on PE

% 50% 60% 100%

Ach 13 batches 3 batches 36 batches

Target 26 batches 5 batches 36 batches

50%60%

100%

0%

20%

40%

60%

80%

100%

AFHS-ANM/LHV AFHS-counsellors TOT for ANM on PE

IYCF training at State level

Training of Counsellors, RKSK


Training Status Report Rastriya Bal Swasthya Karyakram (RBSK): The Government of India under National Health Mission has launched Rastriya Bal Swasthya Karyakram in order to improve the quality of life of children and to provide comprehensive care to all the children in the community. This programme involves screening of children from birth to 18 years of age for 4Ds - Defects at birth, Diseases, Deficiencies and Development delays including disabilities.

2016-17 Training of MHT

DEIC Training

Training of Opth. Surg. on

RoP

Training of Opth. Surg. On

Clubfoot Mgt

1 day training of MO& other staff of DP on New

Born screening

% 44% 9% 20% 11% 42%

Ach 7 batches 38 per 2 per 4 per 8 batches

Target 16 batches 410 per 10 per 35 per 19 batches

44%

9%20%

11%

42%

0%10%20%30%40%50%60%70%80%90%

100%

Trg of MHT Trg of DEIC Trg of Opth. Surg. Trg on Clubfoot Mgt Trg on New Born screening

RBSK training at District level


Training Status Report Trauma & Emergency Medical Care Training (TEMC):

TEMC training is important to stabilize the trauma victims. TEMC training is mandatory as per the order of the Road Safety Committee of Hon’ble Supreme Court. In view of the above requirement NHM, Odisha has initiated TEMC training during 2015-16 for DHH & SDH. After training, DHH & SDH are strengthened to provide quality TEMC services to the trauma victims. TOT organized at AIIMS, BBSR. Three Medical College & Hospitals (MCHs) are designated as Regional Training Centre’ for district and sub-district level training. After TOT 3 Govt. MCHs have conducted training of the service providers at Dept. of Anesthesiology.

Training Target Achievement %

State ToT 20 17 85%

District

training 308 258 84%

NLEP:

85% 84%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

State ToT Distrcit trg.

Trainees are in TEMC trg at SCB

ToT in T&EMC training at SCB MCH, Cuttack


Training Status Report NLEP: Leprosy bacillus has very weak potential of causing the disease and they multiply very slowly as compared to most other bacteria. In order to strengthen the process of elimination in the community, MOs, AYUSH MOs, MPHWs are trained in phases manner.

National Vector Born Disease Control Programme (NVBDCP): National Vector Borne Disease Control Programme (NVBDCP) is for prevention and control of vector borne diseases like Malaria, Dengue, Lymphatic Filariasis, Kala-azar etc.

NVBDCP: 2016-17

100% 100%85%

0%10%20%30%40%50%60%70%80%90%

100%

Modular trg for AYUSH

MOs

Modular trg for MOs

Training for HW / HS

73%

90%

100%

33%

100% 100%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Trg. of IMA & IAP MembersRef. Trg. of ASHAInduction Trg. MTS Ref. Trg. MTSInduction & Ref.Trg. LTsDVBD Ref.Trg.

Name of the Training Target Ach. %

AYUSH Mos 2days modular training on Leprosy

150 166 100

MBBS MOs 3days modular training on Leprosy

240 241 100

HW / HS 3days training on leprosy 60 51 85

Achievement: 2016-17

NVBDCP training at State level


Training Status Report NVBDCP: 2016-17

NVBDCP Training Target / Achievement 2016-17 Training Target Achievement %

Trg. of IMA & IAP Members 30 22 73%

Ref. Trg. of ASHA 30 27 90%

Induction Trg. MTS 1 1 100%

Ref. Trg. MTS 6 2 33%

Induction & Ref.Trg. LTs 5 5 100%

DVBD Ref.Trg. 1 1 100% Trg of Paramedicals 2500 2500 100% Trg of Drug Adminstrator 14300 14300 100% Trg of MOI/C, Ayush MO, PHEO, MTS, MPHS 375 375 100%

Trg of DMO, VBDC, DPHEO 30 30 100% Syphilis: As per the approve PIP, Odisha State AIDS Control Society ( OSACS) organised TOT and district level training for screening on syphilis. Training achievement during FY:2016-17 is as follows:

100% 100% 100% 100%

0%10%20%30%40%50%60%70%80%90%

100%

Trg of Paramedicals Trg of Drug Adminstrator Trg of MOI/C, Ayush MO, PHEO, MTS, MPHS

Trg of DMO, VBDC, DPHEO

Training Target Ach. %

State ToT 1 batch 1 batch 100%

District training 20 batch 11 batch 55%

100%

55%

0%

20%

40%

60%

80%

100%

State ToT Distrcit trg.


Training Status Report PPTCT:

Training Target Achievement % Medical Personnel 29 batches 28 batches 97% ParaMedical personnel 57 batches 53 batches 93%

Dakshata: Dakshata training is to improve the quality of maternal health services at high case load (≥50 per month) facilities through OSCE (Objective Structured Clinical Examination) which includes-

a) Rapid assessments and periodic assessments through standardized formats, in order to identify and address resource gaps, and to track the improvement.

b) Focussed and customized skill based trainings, through a pool of trained master trainers and a series of State, Regional and district level trainings.

c) Strategy for transfer of learning through intense mentoring and support visit to improve labour room standards and clinical skills through on site mentoring.

d) Improved monitoring accountability, strengthening data recording, reporting systems and ensuring use of standard checklists.

Achievement under DAKSHATA :

Training Target Ach. %

Regional ToT (Batch) 1 3 >100%

District training (Batch) 68 56 82%

100%82%

0%

20%

40%

60%

80%

100%

Regionla ToT Distrcit trg.

97% 93%

0%

20%

40%

60%

80%

100%

Medical Personnel ParaMedical personnel

DAKSHATA training at District level

PPTCT training at State level


Training Status Report e- Learning Course: Human Resource (HR) development in public health is the requirement of NHM. To ensure quality implementation and rational use of resources for better health output at community level, quality public health management at district and block level is the need of the State. To achieve the above objectives NHM, Odisha is providing 1 year Diploma in Health Promotion (DHP), distance education (e-Learning) to create public health manpower in health system. The skill of trained personnel will be utilized for quality implementation of RMNCH+A activities as per approved PIP. Diploma in Health Promotion (DHP) course is conducted in collaboration with NIHFW, New Delhi, Govt. of India.

100% 100% 95%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

SPMU DPMU BPMU

PGDHP SPMU Personnel DPMU Personnel BPMU Personnel

Target 10 30 60

Ach 11 32 57

% 110% 106% 95%

Participants of PGDHP contact prog.


Training Status Report Management Development Programme (MDP): As per the approved PIP:2016-17 officials from state, district and block level have attended Management Development training Programme to enhance their management skill at different reputed institution like, IIHMR, Jeypore, ASCI, Hyderabad, NIHFW, New Delhi.

MDP Prog. officer Fin. officer MIS officer

Target 51 15 54 Ach 73 6 45 % 143% 40% 83%

Nursing Training: As per approved PIP: 2016-17, NHM Odisha, has organised skill assessment training to assess the skills of newly recruited SN & ANMs. After TOT, Master Assessors’ conducted skill assessment session for the newly recruited SN & ANM at district level. This training is conducted following Objective Structured Clinical Examination (OSCE) training methodology to ensure the quality and uniformity in assessment.

Training State

Load

Ach. till

Mar'17

%

6 weeks training at

National Nodal centre

5

batches

5

batches 100%

ToT of Nurse trainer 1batch 1batch 100%

143%

40%

83%

0%

50%

100%

SPMU DPMU BPMU

100% 100%

0%10%20%30%40%50%60%70%80%90%

100%

6 weeks training at National Nodal centre

ToT of Nurse trainer

IMEP Training at ESCI, Hyderabad

ToT of Nurse trainer

Trainees are in 6 weeks training


Training Status Report Innovations in training: Professional Indemnity Bond (PIB):

PIB has been introduced for all trained MBBS doctor in Life Saving Anaesthetic Skills (LSAS) & Emergency Obstetric Care (EmOC) to provide Insurance support for any casualty or health complications due to LSAS & EmOC interventions. Total 175 LSAS & EmOC trained doctors are covered under PIB. Training Bond for LSAS training: Training bond is introduced in LSAS training to ensure that the LSAS trained doctors provide necessary services atleast for 5 years after 18 weeks of LSAS training. Performance Incentive (PI): LSAS & EmOC trained doctors are entitled to get PI as per approved PIP. It is observed that trained doctor may earn maximum Rs. 8000/month at peripheral FRU. Refresher training: To enhance the confidence level of LSAS & EmOC trained doctors, NHM has initiated 2 weeks of refresher training to ensure the quality of services. Public Health Research: In training division, under SHSRC, NHM, different public health research are conducted through different reputed institutions like, IIHMR, Jeypore, TISS, Mumbai, Xavier Institute of Management, Bhubaneswar and Dept. of Community Medicine of 3 Govt. Medical Colleges. During 2016-17, NHM has initiated the following studies:

Health Behaviour of mother (care giver) for neonates among tribal community of Rayagada. Current Prescription Practices in Govt. Hospitals of Odisha. Major causes of Infant death in Bolangir distirct, Odisha.

Training organized for Neighboring States:

As per the recommendation of MH Division, MoH&FW, Govt. of India, Training Division, NHM, Odisha has organized Life Saving Anesthetic Skills (LSAS) training for the state of Meghalaya ( 3 MBBS doctors) and Tripura ( 2 MBBS doctors) at Dept. of Anesthesiology, SCB MCH, Cuttack during the year 2015-16 & 2016-17.

In the year 2016-17, NHM Odisha is organizing Emergency Obstetric Care (EmOC) training for 4 MBBS doctors of Dept. of H&FW, Govt. of Tripura at Dept. of OG, SCB MCH, Cuttack.


Training Status Report Approved budget FY: 2016-17

Thematic Division RH MH N&CH RBSK RKSK

Pro. Mgt. Ttrg.

IEC/ BCC Others Nursing Total

Total Budget 203.04 469.31 284.31 202.01 487.03 181.24 32.36 162.1 200.97 2222.37

% of Total

Budget 9% 21% 13% 9% 22% 8% 1% 7% 9% 100%

Funds Utilization : 2016-17

2016-17 Total RH MH N&CH RKSK Prog.

Mgt. RBSK Nursing Other Trg

% 50% 12% 76% 63% 67% 99% 13% 71% 97%

Ach 773.08 57.25 211.17 127.58 60.3 129 24.58 78.52 84.68

Target 1555.52 469.68 279.11 203.04 90.43 129.68 186.32 109.98 87.28

9%

21%

13%

9%

22%

8%1%

7%

9%

Total Training Budget : 2222.37 lakh RH

MH

N&CH

RBSK

RKSK

Pro. Mg. Trg.

IEC/BCC

Ohers

Nursing

50%

12%

76%

63% 67%

99%

13%

71%

97%

0%10%20%30%40%50%60%70%80%90%

100%

Total RH MH N&CH RKSK Prog.Mgt. RBSK Nursing Other Trg




% 50% 12% 76% 63% 67% 99% 13% 71% 97%

Ach 773.08 57.25 211.17 127.58 60.3 129 24.58 78.52 84.68

Target 1555.52 469.68 279.11 203.04 90.43 129.68 186.32 109.98 87.28

50%

12%

76%

63% 67%

99%

13%

71%

97%

0%10%20%30%40%50%60%70%80%90%

100%


Training Status Report: 2016-17

Mission Directorate National Health Mission

Annex Building, SIH&FW, Unit -8 Bhubaneswar – 751012, Odisha

Phone/ Fax-0674-2392479/80 E-mail: [email protected],

www.nrhmorissa.gov.in

T R A I N I N G U N I T , N H M - O D I S H A

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